针刺治疗缺血性脑卒中的实验研究进展

Research progress in experimental research on acupuncture treatment for ischemic stroke

世界卫生组织推荐针刺作为脑卒中治疗和改善脑卒中预后的替代和补充治疗方案。临床试验和荟萃分析结果证明,针刺在提高平衡功能、减少痉挛、增加肌力和改善脑卒中后患者总体的健康状况具有确切疗效。针刺在脑卒中康复中的作用机理尚不清楚。本研究的目的是进行文献综述,总结目前已知的针刺和电针治疗缺血性脑卒中治疗的机制,并详细说明这些作用中涉及的常用穴位。这篇综述中的证据表明,缺血性脑卒中康复期应用针刺及电针治疗涉及5种主要机制:促进中枢神经系统的神经生长和神经细胞增殖;调节和改善缺血区脑血流的分布;缺血区抗凋亡作用;相关神经化学物质的调控;改善脑卒中后受损功能区的认知功能和记忆。针刺可通过上述作用机制,改善缺血性脑卒中的预后。

Acupuncture has been recommended by the World Health Organization as an alternative and complementary treatment for stroke therapy and improvement of stroke outcome.Clinical trials and meta-analyses have demonstrated the definite therapeutic effects of acupuncture in promoting balance function,reducing spasticity,increasing muscle strength,and strengthening overall health status in post-stroke patients.However,the mechanisms underlying the beneficial effects of acupuncture in stroke rehabilitation are still unclear.The purpose of this paper is to conduct a literature review,summarize the known mechanisms of acupuncture and electroacupuncture in the rehabilitation of ischemic stroke,and provide detailed explanations of the commonly used acupoints involved in these effects.The evidence presented in this review indicates that the beneficial effects of acupuncture and electroacupuncture in ischemic stroke rehabilitation involve five major mechanisms:promotion of neurogenesis and neuronal proliferation in the central nervous system,regulation and improvement of cerebral blood flow distribution in the ischemic area,anti-apoptotic effects in the ischemic area,modulation of relevant neurochemical substances,and potentiation of cognitive function and memory in the damaged functional area after stroke.Acupuncture can improvement stroke outcome through the above mechanisms.